Experience-Dependent Neural Integration of Taste and Smell in the Human Brain

Multisensory Integration Underlies the Distinct Representation of Odor-Taste Mixtures in the Gustatory Cortex of Behaving Rats

The perception of food relies on the integration of olfactory and gustatory signals originating from the mouth. This multisensory process generates robust associations between odors and tastes, significantly influencing the perceptual judgment of flavors. However, the specific neural substrates underlying this integrative process remain unclear. Previous electrophysiological studies identified the gustatory cortex as a site of convergent olfactory and gustatory signals, but whether neurons represent multimodal odor-taste mixtures as distinct from their unimodal odor and taste components is unknown. To investigate this, we recorded single-unit activity in the gustatory cortex of behaving female rats during the intraoral delivery of individual odors, individual tastes, and odor-taste mixtures. Our results demonstrate that chemoselective neurons in the gustatory cortex are broadly responsive to intraoral chemosensory stimuli, exhibiting time-varying multiphasic changes in activity. In a subset of these chemoselective neurons, odor-taste mixtures elicit nonlinear cross-modal responses that distinguish them from their olfactory and gustatory components. These findings provide novel insights into multimodal chemosensory processing by the gustatory cortex, highlighting the distinct representation of unimodal and multimodal intraoral chemosensory signals. Overall, our findings suggest that olfactory and gustatory signals interact nonlinearly in the gustatory cortex to enhance the identity coding of both unimodal and multimodal chemosensory stimuli.

Ménage à trois: light, terpenoids, and quality of plants

In controlled environment agriculture (CEA), light is used to impact terpenoid production and improve plant quality. In this review we discuss various aspects of light as important regulators of terpenoid production in different plant organs. Spectral quality primarily modifies terpenoid profiles, while intensity and photoperiod influence abundances. The central regulator of light signal transduction elongated hypocotyl 5 (HY5) controls transcriptional regulation of terpenoids under UV, red (R), and blue (B) light. The larger the fraction of R and green (G) light, the more beneficial the effect on monoterpenoid and sesquiterpenoid biosynthesis, and such an effect may depend on the presence of B light. A large fraction of R light is mostly detrimental to tetraterpenoid production. We conclude that light is a promising tool to steer terpenoid production and potentially tailor the quality of plants.

The effect of multisensory context and experience on flavor preference decisions in rats

Flavor is perceived through multiple senses, including gustation and olfaction. Previous studies have shown that different sensory qualities that make up flavor are integrated to inform perceptual judgements. Psychophysical work in humans further suggests a prominent role for congruency (i.e., the learnt correspondence between taste and odor components of flavor through eating experience) in shaping multisensory interactions underlying perceptual judgments of flavor. However, eating experience cannot be controlled in humans, and depending on the type of judgement, these studies yielded mixed findings. Here, we used rats to test how experimentally-controlled experience with specific flavor mixtures (OdorA+TasteA and OdorB +TasteB) from weaning to adulthood affects subsequent flavor preference judgements in a series of two-bottle preference tests. In unisensory conditions, animals made odor or taste preference decisions (i.e., OdorA versus OdorB and TasteA versus TasteB, respectively). In multisensory conditions, animals made identical decisions, but the addition of the other modality rendered one solution congruent; the other one incongruent (e.g., OdorA+TasteA versus OdorB+TasteA). The results show that animals effectively learned congruency associations between the taste and smell components of experienced flavor mixtures. Comparing unisensory and multisensory conditions revealed no systematic effect of congruency on the magnitude of flavor preference, but preferences were less variable in multisensory compared to unisensory conditions. Results from a second group of naïve animals further demonstrate that increased reliability of preference judgements in multisensory conditions was independent of experience.

An intra-oral flavor detection task in freely moving mice

Flavor plays a critical role in the pleasure of food. Flavor research has mainly focused on human subjects and revealed that many brain regions are involved in flavor perception. However, animal models for elucidating the mechanisms of neural circuits are lacking. Herein, we demonstrate the use of a novel behavioral task in which mice are capable of flavor detection. When the olfactory pathways of the mice were blocked, they could not perform the task. However, behavioral accuracy was not affected when the gustatory pathway was blocked by benzocaine. These results indicate that the mice performed this detection task mainly based on the olfaction. We conclude that this novel task can contribute to research on the neural mechanisms of flavor perception.

Sniffing out meaning: Chemosensory and semantic neural network changes in sommeliers

Wine tasting is a very complex process that integrates a combination of sensation, language, and memory. Taste and smell provide perceptual information that, together with the semantic narrative that converts flavor into words, seem to be processed differently between sommeliers and naïve wine consumers. We investigate whether sommeliers' wine experience shapes only chemosensory processing, as has been previously demonstrated, or if it also modulates the way in which the taste and olfactory circuits interact with the semantic network. Combining diffusion-weighted images and fMRI (activation and connectivity) we investigated whether brain response to tasting wine differs between sommeliers and nonexperts (1) in the sensory neural circuits representing flavor and/or (2) in the neural circuits for language and memory. We demonstrate that training in wine tasting shapes the microstructure of the left and right superior longitudinal fasciculus. Using mediation analysis, we showed that the experience modulates the relationship between fractional anisotropy and behavior: the higher the fractional anisotropy the higher the capacity to recognize wine complexity. In addition, we found functional differences between sommeliers and naïve consumers affecting the flavor sensory circuit, but also regions involved in semantic operations. The former reflects a capacity for differential sensory processing, while the latter reflects sommeliers' ability to attend to relevant sensory inputs and translate them into complex verbal descriptions. The enhanced synchronization between these apparently independent circuits suggests that sommeliers integrated these descriptions with previous semantic knowledge to optimize their capacity to distinguish between subtle differences in the qualitative character of the wine.

Mushroom alcohol(1-octen-3-ol)and other 7 aroma compounds selected from Chinese dry-cured hams can enhance saltiness perception

Reducing NaCl content in food while maintaining acceptability poses a significant challenge. Odor-induced saltiness enhancement (OISE) emerges as a promising solution. This study utilized gas chromatography-olfactory (GC-O) in conjunction with gas chromatography-mass spectrometry (GC-MS) to identify 37 key volatile compounds in three representative Chinese dry-cured hams. These compounds had an odor activity value (OAV) of ≥1 or a modification frequency (MF) of ≥30%. Subsequently, quantitative descriptive analysis (QDA) identified eight odorants associated with saltiness. These included 1-octen-3-ol, nonanal, heptanal, 2-methylbutanal, 3-methyl-butanal, benzaldehyde, octanal, and 2,6-dimethylpyrazine. Remarkably, these odorants significantly intensified saltiness (P < 0.05) when added to a low-concentration NaCl solution (0.3%), compared to zero or high concentrations (0.75% and 0.8%). As a result, traditional Chinese salty meat products offer a promising source of odorants for enhancing saltiness, compensating for reduced NaCl content through OISE.

A Neural Mechanism in the Human Orbitofrontal Cortex for Preferring High-Fat Foods Based on Oral Texture

Although overconsumption of high-fat foods is a major driver of weight gain, the neural mechanisms that link the oral sensory properties of dietary fat to reward valuation and eating behavior remain unclear. Here we combine novel food-engineering approaches with functional neuroimaging to show that the human orbitofrontal cortex (OFC) translates oral sensations evoked by high-fat foods into subjective economic valuations that guide eating behavior. Male and female volunteers sampled and evaluated nutrient-controlled liquid foods that varied in fat and sugar ("milkshakes"). During oral food processing, OFC activity encoded a specific oral-sensory parameter that mediated the influence of the foods' fat content on reward value: the coefficient of sliding friction. Specifically, OFC responses to foods in the mouth reflected the smooth, oily texture (i.e., mouthfeel) produced by fatty liquids on oral surfaces. Distinct activity patterns in OFC encoded the economic values associated with particular foods, which reflected the subjective integration of sliding friction with other food properties (sugar, fat, viscosity). Critically, neural sensitivity of OFC to oral texture predicted individuals' fat preferences in a naturalistic eating test: individuals whose OFC was more sensitive to fat-related oral texture consumed more fat during ad libitum eating. Our findings suggest that reward systems of the human brain sense dietary fat from oral sliding friction, a mechanical food parameter that likely governs our daily eating experiences by mediating interactions between foods and oral surfaces. These findings identify a specific role for the human OFC in evaluating oral food textures to mediate preference for high-fat foods.SIGNIFICANCE STATEMENT Fat and sugar enhance the reward value of food by imparting a sweet taste and rich mouthfeel but also contribute to overeating and obesity. Here we used a novel food-engineering approach to realistically quantify the physical-mechanical properties of high-fat liquid foods on oral surfaces and used functional neuroimaging while volunteers sampled these foods and placed monetary bids to consume them. We found that a specific area of the brain's reward system, the orbitofrontal cortex, detects the smooth texture of fatty foods in the mouth and links these sensory inputs to economic valuations that guide eating behavior. These findings can inform the design of low-calorie fat-replacement foods that mimic the impact of dietary fat on oral surfaces and neural reward systems.

Intraoral thermal processing in the gustatory cortex of awake mice

Oral temperature is a sensory cue relevant to food preference and nutrition. To understand how orally-sourced thermal inputs are represented in the gustatory cortex (GC) we recorded neural responses from the GC of male and female mice presented with deionized water at different innocuous temperatures (14 °C, 25 °C, 36 °C) and taste stimuli (room temperature). Our results demonstrate that GC neurons encode orally-sourced thermal information in the absence of classical taste qualities at the single neuron and population levels, as confirmed through additional experiments comparing GC neuron responses to water and artificial saliva. Analysis of thermal-evoked responses showed broadly tuned neurons that responded to temperature in a mostly monotonic manner. Spatial location may play a minor role regarding thermosensory activity; aside from the most ventral GC, neurons reliably responded to and encoded thermal information across the dorso-ventral and antero-postero cortical axes. Additional analysis revealed that more than half of GC neurons that encoded chemosensory taste stimuli also accurately discriminated thermal information, providing additional evidence of the GC's involvement in processing thermosensory information important for ingestive behaviors. In terms of convergence, we found that GC neurons encoding information about both taste and temperature were broadly tuned and carried more information than taste-selective only neurons; both groups encoded similar information about the palatability of stimuli. Altogether, our data reveal new details of the cortical code for the mammalian intraoral thermosensory system in behaving mice and pave the way for future investigations on GC functions and operational principles with respect to thermogustation.

Enhancing saltiness perception by chemosensory interaction: an fMRI study

Neuroimaging studies that focus on taste, odor, and their interactions can specify their capability to elicit brain regions responsible for flavor perception and reward. Such information would be useful for formulating healthy food products, such as low salt food. In this study, a sensory experiment was conducted to investigate the capability of cheddar cheese odor, monosodium glutamate (MSG), and their interactions to enhance saltiness perception and preference of NaCl solutions. The activated brain areas in response to odor-taste-taste interactions were then investigated using an fMRI study. The results of the sensory tests showed that saltiness and preference of NaCl solutions were enhanced in the presence of MSG + cheddar cheese odor. According to the fMRI study, the stimulus with a higher salty rate activated the rolandic operculum, and the stimulus with a higher preference activated the rectus, medial orbitofrontal cortex, and substantia nigra. Moreover, the activation of multiple regions, such as the orbitofrontal cortex (OFC), anterior cingulate cortex (ACC), temporal pole, and amygdala was observed in response to (cheddar cheese odor + MSG + NaCl) minus (odorless air + NaCl).

The Potential Role of Gustatory Function as an Early Diagnostic Marker for the Risk of Alzheimer’s Disease in Subjective Cognitive Decline

Background: Patients with subjective cognitive decline (SCD) report memory deterioration and are at an increased risk of converting to Alzheimer’s disease (AD) although psychophysical testing does not reveal any cognitive deficit. Objective: Here, gustatory function is investigated as a potential predictor for an increased risk of progressive cognitive decline indicating higher AD risk in SCD. Methods: Measures of smell and taste perception as well as neuropsychological data were assessed in patients with subjective cognitive decline (SCD): Subgroups with an increased likelihood of the progression to preclinical AD (SCD+) and those with a lower likelihood (SCD–) were compared to healthy controls (HC), patients with mild cognitive impairment and AD patients. The Sniffin’ Sticks test contained 12 items with different qualities and taste was measured with 32 taste stripes (sweet, salty, bitter, sour) of different concentration. Results: Only taste was able to distinguish between HC/SCD– and SCD+ patients. Conclusion: This study provides a first hint of taste as a more sensitive marker than smell for detecting preclinical AD in SCD. Longitudinal observation of cognition and pathology are necessary to further evaluate taste perception as a predictor of pathological objective decline in cognition.

Neural correlates of multisensory integration in the human brain: an ALE meta-analysis

Previous fMRI research identified superior temporal sulcus as central integration area for audiovisual stimuli. However, less is known about a general multisensory integration network across senses. Therefore, we conducted activation likelihood estimation meta-analysis with multiple sensory modalities to identify a common brain network. We included 49 studies covering all Aristotelian senses i.e., auditory, visual, tactile, gustatory, and olfactory stimuli. Analysis revealed significant activation in bilateral superior temporal gyrus, middle temporal gyrus, thalamus, right insula, and left inferior frontal gyrus. We assume these regions to be part of a general multisensory integration network comprising different functional roles. Here, thalamus operate as first subcortical relay projecting sensory information to higher cortical integration centers in superior temporal gyrus/sulcus while conflict-processing brain regions as insula and inferior frontal gyrus facilitate integration of incongruent information. We additionally performed meta-analytic connectivity modelling and found each brain region showed co-activations within the identified multisensory integration network. Therefore, by including multiple sensory modalities in our meta-analysis the results may provide evidence for a common brain network that supports different functional roles for multisensory integration.

The orbitofrontal cortex, food reward, body weight and obesity

In primates including humans, the orbitofrontal cortex is the key brain region representing the reward value and subjective pleasantness of the sight, smell, taste and texture of food. At stages of processing before this, in the insular taste cortex and inferior temporal visual cortex, the identity of the food is represented, but not its affective value. In rodents, the whole organisation of reward systems appears to be different, with reward value reflected earlier in processing systems. In primates and humans, the amygdala is overshadowed by the great development of the orbitofrontal cortex. Social and cognitive factors exert a top-down influence on the orbitofrontal cortex, to modulate the reward value of food that is represented in the orbitofrontal cortex. Recent evidence shows that even in the resting state, with no food present as a stimulus, the liking for food, and probably as a consequence of that body mass index, is correlated with the functional connectivity of the orbitofrontal cortex and ventromedial prefrontal cortex. This suggests that individual differences in these orbitofrontal cortex reward systems contribute to individual differences in food pleasantness and obesity. Implications of how these reward systems in the brain operate for understanding, preventing and treating obesity are described.

The oral manifestations and related mechanisms of COVID-19 caused by SARS-CoV-2 infection

Coronavirus disease 2019 (COVID-19) was reported to be associated with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, and patients present mostly with respiratory symptoms. There have been an increasing number of reports on oral manifestations, and some of these signs are informative in terms of identifying SARS-CoV-2 infection. The goal of present study was to review and synthesize the clinical characteristics and underlying mechanisms of COVID-19 oral manifestations, as well as to evaluate the factors influencing SARS-CoV-2 infectivity, in order to conduct further in-depth investigations and help clinicians diagnose COVID-19 patients exhibiting oral symptoms.

Oral thermal processing in the gustatory cortex of awake mice

Oral temperature is a sensory cue relevant to food preference and nutrition. To understand how orally sourced thermal inputs are represented in the gustatory cortex (GC), we recorded neural responses from the GC of male and female mice presented with deionized water at different innocuous temperatures (14 °C, 25 °C, and 36 °C) and taste stimuli (room temperature). Our results demonstrate that GC neurons encode orally sourced thermal information in the absence of classical taste qualities at the single neuron and population levels, as confirmed through additional experiments comparing GC neuron responses to water and artificial saliva. Analysis of thermal-evoked responses showed broadly tuned neurons that responded to temperature in a mostly monotonic manner. Spatial location may play a minor role regarding thermosensory activity; aside from the most ventral GC, neurons reliably responded to and encoded thermal information across the dorso-ventral and antero-postero cortical axes. Additional analysis revealed that more than half of the GC neurons that encoded chemosensory taste stimuli also accurately discriminated thermal information, providing additional evidence of the GC's involvement in processing thermosensory information important for ingestive behaviors. In terms of convergence, we found that GC neurons encoding information about both taste and temperature were broadly tuned and carried more information than taste-selective-only neurons; both groups encoded similar information about the palatability of stimuli. Altogether, our data reveal new details of the cortical code for the mammalian oral thermosensory system in behaving mice and pave the way for future investigations on GC functions and operational principles with respect to thermogustation.

Physiological discrimination and correlation between olfactory and gustatory dysfunction in long-term COVID-19

The spread of the SARS-CoV-2 virus produces a new disease termed COVID-19, the underlying physiological mechanisms of which are still being understood. Characteristic of the infection is the compromising of taste and smell. There is a persistent need to discriminate the dysfunctions and correlation between taste and smell, which are probably epiphenomena of other concealed conditions. Anosmic and ageusic long-term COVID-19 patients were re-evaluated after 1 year using a Volabolomic approach with an e-nose recording system coupled with olfactometric and gustometric tests. Here a range of sensory arrangements was found, from normal taste and smell to complete losses. The following patterns of olfactory threshold (OT)-taste threshold-olfactory uni- and cross-modal perception were found anosmia-severe hypogeusia-anosmia; hyposmia-hypogeusia-severe hyposmia; normosmia-ageusia-hyposmia; severe hyposmia -normogeusia-normosmia. There is a strong correlation between OT and olfactory uni- and cross-modal perception, a moderate correlation between olfactory and taste threshold and no correlation between OT and taste threshold. In conclusion, this study provides evidence for the feasibility of testing the chemical senses to directly objectify function in order to discriminate taste from olfactory impairment. Furthermore, it allows to hypothesize a long-term effect of the virus due to neuroinvasion through, probably, the olfactory system with injury in the related multisensory areas of taste and smell.

Exploratory Research on Sweetness Perception: Decision Trees to Study Electroencephalographic Data and Its Relationship with the Explicit Response to Sweet Odor, Taste, and Flavor

Using implicit responses to determine consumers' response to different stimuli is becoming a popular approach, but research is still needed to understand the outputs of the different technologies used to collect data. During the present research, electroencephalography (EEG) responses and self-reported liking and emotions were collected on different stimuli (odor, taste, flavor samples) to better understand sweetness perception. Artificial intelligence analytics were used to classify the implicit responses, identifying decision trees to discriminate the stimuli by activated sensory system (odor/taste/flavor) and by nature of the stimuli ('sweet' vs. 'non-sweet' odors; 'sweet-taste', 'sweet-flavor', and 'non-sweet flavor'; and 'sweet stimuli' vs. 'non-sweet stimuli'). Significant differences were found among self-reported-liking of the stimuli and the emotions elicited by the stimuli, but no clear relationship was identified between explicit and implicit data. The present research sums interesting data for the EEG-linked research as well as for EEG data analysis, although much is still unknown about how to properly exploit implicit measurement technologies and their data.

Not Only COVID-19: Involvement of Multiple Chemosensory Systems in Human Diseases

Chemosensory systems are deemed marginal in human pathology. In appraising their role, we aim at suggesting a paradigm shift based on the available clinical and experimental data that will be discussed. Taste and olfaction are polymodal sensory systems, providing inputs to many brain structures that regulate crucial visceral functions, including metabolism but also endocrine, cardiovascular, respiratory, and immune systems. Moreover, other visceral chemosensory systems monitor different essential chemical parameters of “milieu intérieur,” transmitting their data to the brain areas receiving taste and olfactory inputs; hence, they participate in regulating the same vital functions. These chemosensory cells share many molecular features with olfactory or taste receptor cells, thus they may be affected by the same pathological events. In most COVID-19 patients, taste and olfaction are disturbed. This may represent only a small portion of a broadly diffuse chemosensory incapacitation. Indeed, many COVID-19 peculiar symptoms may be explained by the impairment of visceral chemosensory systems, for example, silent hypoxia, diarrhea, and the “cytokine storm”. Dysregulation of chemosensory systems may underlie the much higher mortality rate of COVID-19 Acute Respiratory Distress Syndrome (ARDS) compared to ARDSs of different origins. In chronic non-infectious diseases like hypertension, diabetes, or cancer, the impairment of taste and/or olfaction has been consistently reported. This may signal diffuse chemosensory failure, possibly worsening the prognosis of these patients. Incapacitation of one or few chemosensory systems has negligible effects on survival under ordinary life conditions but, under stress, like metabolic imbalance or COVID-19 pneumonia, the impairment of multiple chemosensory systems may lead to dire consequences during the course of the disease.

Integrative Hedonic and Homeostatic Food Intake Regulation by the Central Nervous System: Insights from Neuroimaging

Food intake regulation in humans is a complex process controlled by the dynamic interaction of homeostatic and hedonic systems. Homeostatic regulation is controlled by appetitive signals from the gut, adipose tissue, and the vagus nerve, while conscious and unconscious reward processes orchestrate hedonic regulation. On the one hand, sight, smell, taste, and texture perception deliver potent food-related feedback to the central nervous system (CNS) and influence brain areas related to food reward. On the other hand, macronutrient composition stimulates the release of appetite signals from the gut, which are translated in the CNS into unconscious reward processes. This multi-level regulation process of food intake shapes and regulates human ingestive behavior. Identifying the interface between hormones, neurotransmitters, and brain areas is critical to advance our understanding of conditions like obesity and develop better therapeutical interventions. Neuroimaging studies allow us to take a glance into the central nervous system (CNS) while these processes take place. This review focuses on the available neuroimaging evidence to describe this interaction between the homeostatic and hedonic components in human food intake regulation.

Characterization of the Aroma-Active Compounds in Banana (Musa AAA Red green) and Their Contributions to the Enhancement of Sweetness Perception

"Hongmeiren" bananas are popular because of their red peel. Two extraction methods solvent-assisted flavor evaporation and headspace solid-phase microextraction, combined with gas chromatography-olfactometry and gas chromatography-mass spectrometry (GC-MS), were used to analyze the volatile components of "Hongmeiren" bananas. A total of 86 aroma compounds were identified by GC-MS, 62 of which were identified as the major aroma-active compounds with an odor activity value ≥ 1 or modified frequency ≥ 30%. Ethyl (E)-2-butenoate, 4-undecanone, and α-phellandrene were found in bananas for the first time. Sensory experiments showed that eight sweet-associated odorants could significantly achieve the sweetness enhancement effect at 30 g/L sucrose solution by odor-induced changes in taste perception. These experiments suggest that selected odorants can achieve sugar reduction, but with consideration of the sugar concentration. The study of the sweetness enhancement effect of individual compounds provides a more direct theoretical support for sugar reduction in the food industry.

Cortical Hub for Flavor Sensation in Rodents

The experience of eating is inherently multimodal, combining intraoral gustatory, olfactory, and somatosensory signals into a single percept called flavor. As foods and beverages enter the mouth, movements associated with chewing and swallowing activate somatosensory receptors in the oral cavity, dissolve tastants in the saliva to activate taste receptors, and release volatile odorant molecules to retronasally activate olfactory receptors in the nasal epithelium. Human studies indicate that sensory cortical areas are important for intraoral multimodal processing, yet their circuit-level mechanisms remain unclear. Animal models allow for detailed analyses of neural circuits due to the large number of molecular tools available for tracing and neuronal manipulations. In this review, we concentrate on the anatomical and neurophysiological evidence from rodent models toward a better understanding of the circuit-level mechanisms underlying the cortical processing of flavor. While more work is needed, the emerging view pertaining to the multimodal processing of food and beverages is that the piriform, gustatory, and somatosensory cortical regions do not function solely as independent areas. Rather they act as an intraoral cortical hub, simultaneously receiving and processing multimodal sensory information from the mouth to produce the rich and complex flavor experience that guides consummatory behavior.

Quantitative but not qualitative flavor recognition impairments in COVID-19 patients

Background

Smell and taste dysfunctions (STDs) are symptoms associated with COVID-19 syndrome, even if their incidence is still uncertain and variable.

Aims

In this study, the effects of SARS-CoV-2 infection on chemosensory function have been investigated using both a self-reporting questionnaire on smell and flavor perception, and a simplified flavor test.

Methods

A total of 111 subjects (19 hospitalized [HOS] and 37 home-isolated [HI] COVID-19 patients, and 55 healthy controls [CTRL]) were enrolled in the study. They received a self-evaluation questionnaire and a self-administered flavor test kit. The flavor test used consists in the self-administration of four solutions with a pure olfactory stimulus (coffee), a mixed olfactory-trigeminal stimulus (peppermint), and a complex chemical mixture (banana).

Results

After SARS-CoV-2 infection, HOS and HI patients reported similar prevalence of STDs, with a significant reduction of both smell and flavor self-estimated perception. The aromas of the flavor test were recognized by HI and HOS COVID-19 patients similarly to CTRL; however, the intensity of the perceived aromas was significantly lower in patients compared to controls.

Conclusion

Data reported here suggests that a chemosensory impairment is present after SARS-CoV-2 infection, and the modified “flavor test” could be a novel self-administering objective screening test to assess STDs in COVID-19 patients.

Clinical trial registration no. NCT04840966; April 12, 2021, retrospectively registered

Supplementary Information

The online version contains supplementary material available at 10.1007/s11845-021-02786-x.

Effective Connectivity in the Human Brain for Sour Taste, Retronasal Smell, and Combined Flavour

The anterior insula and rolandic operculum are key regions for flavour perception in the human brain; however, it is unclear how taste and congruent retronasal smell are perceived as flavours. The multisensory integration required for sour flavour perception has rarely been studied; therefore, we investigated the brain responses to taste and smell in the sour flavour-processing network in 35 young healthy adults. We aimed to characterise the brain response to three stimulations applied in the oral cavity—sour taste, retronasal smell of mango, and combined flavour of both—using functional magnetic resonance imaging. Effective connectivity of the flavour-processing network and modulatory effect from taste and smell were analysed. Flavour stimulation activated middle insula and olfactory tubercle (primary taste and olfactory cortices, respectively); anterior insula and rolandic operculum, which are associated with multisensory integration; and ventrolateral prefrontal cortex, a secondary cortex for flavour perception. Dynamic causal modelling demonstrated that neural taste and smell signals were integrated at anterior insula and rolandic operculum. These findings elucidated how neural signals triggered by sour taste and smell presented in liquid form interact in the brain, which may underpin the neurobiology of food appreciation. Our study thus demonstrated the integration and synergy of taste and smell.

Multisensory interactions underlying flavor consumption in rats: the role of experience and unisensory component liking

The mechanisms by which taste and odor are combined in determining food choice behavior are poorly understood. Previous work in human subjects has yielded mixed results, potentially due to differences in task context across studies, and a lack of control over flavor experience. Here, we used rats as a model system to systematically investigate the role of experience and unisensory component liking in the multisensory interactions underlying consumption behavior. We demonstrate that taste–smell mixture consumption is best explained by a linear average of component liking. The observed pattern of results was not dependent on prior experience with specific taste–smell combinations, and unique for multisensory as opposed to unisensory mixture consumption. The results are discussed with respect to existing models of flavor integration, and a maximum-likelihood integration model previously described for multisensory judgments in other systems.

Clinical Implications of Psychophysical Olfactory Testing: Assessment, Diagnosis, and Treatment Outcome

Purpose of Review

Olfactory dysfunction dramatically impairs quality of life with a prevalence of 20% in the general adult population. Psychophysical olfactory testing has been widely used to evaluate the ability to smell due to its validated utility and feasibility in clinic. This review summarizes the current literature regarding psychophysical olfactory testing and the clinical relevance of the olfactory testing with different components. Furthermore, the review highlights the diagnosis and treatment value of olfactory subtests in patients with olfactory dysfunction.

Recent Findings

With the accumulation of studies of psychophysical olfactory testing in olfactory disorders, the clinical relevance of olfactory testing with different components is expanding. Different olfactory domains present with distinct olfactory processing and cortical activity. Psychophysical assessment of olfaction with three domains reveals different levels of olfactory processing and might assist with analyzing the pathophysiologic mechanism of the various olfactory disorders. Furthermore, olfactory thresholds provided the largest amount of non-redundant information to the olfactory diagnosis. Sinonasal olfactory dysfunction and non-sinonasal-related olfactory dysfunction are emerging classifications of smell disorders with certain characteristics of olfactory impairment and different responses to the therapy including steroids, sinus surgery, and olfactory training.

Summary

These recent advancements should promote the understanding of psychophysical olfactory testing, the association between individual subcomponents and neurophysiological processes, and pave the way for precision assessment and treatment of the olfactory dysfunction.

Odor-Taste Interactions in Food Perception: Exposure Protocol Shows No Effects of Associative Learning

Repeated exposure can change the perceptual and hedonic features of flavor. Associative learning during which a flavor's odor component is affected by co-exposure with taste is thought to be central in this process. However, changes can also arise due to exposure to the odor in itself. The aim of this study was to dissociate effects of associative learning from effects of exposure without taste by repeatedly presenting one odor together with sucrose and a second odor alone. Sixty individuals attended two testing sessions separated by a 5-day Exposure Phase during which the stimuli were presented as flavorants in chewing gums that were chewed three times daily. Ratings of odor sweetness, odor pleasantness, odor intensity enhancement by taste, and odor referral to the mouth were collected at both sessions. Consistent with the notion that food preferences are modulated by exposure, odor pleasantness increased between the sessions independently of whether the odor (basil or orange flower) had been presented with or without sucrose. However, we found no evidence of associative learning in any of the tasks. In addition, exploratory equivalence tests suggested that these effects were either absent or insignificant in magnitude. Taken together, our results suggest that the hypothesized effects of associative learning are either smaller than previously thought or highly dependent on the experimental setting. Future studies are needed to evaluate the relative support for these explanations and, if experimental conditions can be identified that reliably produce such effects, to identify factors that regulate the formation of new odor-taste associations.

Adaptive weighting of taste and odor cues during flavor choice

Colloquially referred to as "taste," flavor is in reality a thoroughly multisensory experience. Yet, a mechanistic understanding of the multisensory computations underlying flavor perception and food choice is lacking. Here, we used a multisensory flavor choice task in rats to test specific predictions of the statistically optimal integration framework, which has previously yielded much insight into cue integration in other multisensory systems. Our results confirm three key predictions of this framework in the unique context of flavor choice behavior, providing novel mechanistic insight into multisensory flavor processing.NEW & NOTEWORTHY The authors demonstrate that rats make choices about which flavor solution (i.e., taste-odor mixture) to consume by weighting the individual taste and odor components according to the reliability of the information they provide about which solution is the preferred one. A similar weighting operation underlies multisensory cue combination in other domains and offers novel insight into the computations underlying multisensory flavor perception and food choice behavior.

Sugar Reduction in Dairy Food: An Overview with Flavoured Milk as an Example

Owing to the public health concern associated with the consumption of added sugar, the World Health Organization recommends cutting down sugar in processed foods. Furthermore, due to the growing concern of increased calorie intake from added sugar in sweetened dairy foods, the present review provides an overview of different types and functions of sugar, various sugar reduction strategies, and current trends in the use of sweeteners for sugar reduction in dairy food, taking flavoured milk as a central theme where possible to explore the aforementioned aspects. The strength and uniqueness of this review are that it brings together all the information on the available types of sugar and sugar reduction strategies and explores the current trends that could be applied for reducing sugar in dairy foods without much impact on consumer acceptance. Among different strategies for sugar reduction, the use of natural non-nutritive sweeteners (NNSs), has received much attention due to consumer demand for natural ingredients. Sweetness imparted by sugar can be replaced by natural NNSs, however, sugar provides more than just sweetness to flavoured milk. Sugar reduction involves multiple technical challenges to maintain the sensory properties of the product, as well as to maintain consumer acceptance. Because no single sugar has a sensory profile that matches sucrose, the use of two or more natural NNSs could be an option for food industries to reduce sugar using a holistic approach rather than a single sugar reduction strategy. Therefore, achieving even a small sugar reduction can significantly improve the diet and health of an individual.

Flavor identification inversely correlates with body mass index (BMI)

BACKGROUND AND AIMS

Dietary choices are influenced by several factors including physiological, social, or genetic factors. Among these, flavor is the most important determinant modulating food preferences. The aim of the present study was to assess flavor identification abilities in patients with obesity (Ob) in comparison with matched normal weight (NW) and over-weight (OW) subjects using a specific and validated chemosensory test.

METHODS AND RESULTS

The flavor test was administered to 140 Ob patients recruited in the obesity outpatient Unit at the Federico II University hospital and to the same number of NW and OW subjects matched by sex, age, and smoking habit. Flavor score (FS) inversely correlated with BMI. Median [Q1; Q3] FS was significantly higher in NW (14.5 [12; 16]) than in Ob (13 [10; 15] p < 0.001) and not significantly different from OW (14 [12; 16]) individuals. FS was also higher in OW than in Ob subjects (p < 0.005). When separated according to age quartiles, the BMI-related differences in FS were still significant in younger quartiles, while they were abolished in the older.

CONCLUSIONS

BMI is a critical factor modulating flavor identification, particularly in young subjects. Further investigations are needed to explore the precise mechanism and the causal relationship between body weight and olfactory dysfunctions.

CLINICALTRIAL ID

NCT03506074.

Obesity and COVID-19: Oro-Naso-Sensory Perception

Through a recent upsurge of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic, the clinical assessment of most of the coronavirus disease 19 (COVID-19) patients clearly presents a health condition with the loss of oro-naso-sensory (ONS) perception, responsible for the detection of flavor and savor. These changes include anosmia and dysgeusia. In some cases, these clinical manifestations appear even before the general flu-like symptoms, e.g., sore throat, thoracic oppression and fever. There is no direct report available on the loss of these chemical senses in obese COVID-19 patients. Interestingly, obesity has been shown to be associated with low ONS cues. These alterations in obese subjects are due to obesity-induced altered expression of olfacto-taste receptors. Besides, obesity may further aggravate the SARS-CoV-2 infection, as this pathology is associated with a high degree of inflammation/immunosuppression and reduced protection against viral infections. Hence, obesity represents a great risk factor for SARS-CoV-2 infection, as it may hide the viral-associated altered ONS symptoms, thus leading to a high mortality rate in these subjects.

Association Between Orthonasal Olfaction and Chemosensory Perception in Patients With Smell Loss

Objectives

Self‐ratings seem to be the most effortless strategy for assessment of patients' chemical senses. Notably, although flavor perception strongly relies on olfaction, the relationship between self‐reported flavor perception and orthonasal olfactory tests have hitherto not been considered. The aim of this study was to investigate the relationship between self‐perceived olfactory function (SO), taste (ST), and flavor perception (SF) and smell test results in patients with olfactory dysfunction (OD).

Methods

We included 203 patients with quantitative OD. Group comparison, bivariate correlation, and ordinal logistic regression were employed to quantify the relationships between predictor variables (age, gender, reason for OD, and orthonasal olfaction—summed scores of threshold, discrimination, and identification [TDI]) and outcomes of SO and SF (“impaired,” “average,” or “good”).

Results

Group comparison revealed significant differences between SO and SF (P < .001). Stronger correlations were found between SO and TDI (r = 0.64), compared to SF and TDI (r = 0.27). No relevant correlation was found between ST and TDI (r = 0.10). Higher TDI was associated with odds of higher SO in univariate (odds ratio = 1.25) and multivariable analyses (adjusted odds ratio = 1.23), and both models showed good fit of data. Conversely, regression models on the associations between TDI and changes in SF did not meet the assumption of goodness of fit.

Conclusion

We found that higher orthonasal olfactory performance was associated with odds of higher SO in patients with OD, even after controlling for olfactory‐relevant factors. To the contrary, similar models based on flavor perception failed to describe these relationships. This indicates for SF and ST to be less represented by the TDI compared to SO.

Level of Evidence

4 Laryngoscope, 130:2213–2219, 2020

Experience Informs Consummatory Choices for Congruent and Incongruent Odor-Taste Mixtures in Rats

Experience is an essential factor informing food choice. Eating food generates enduring odor-taste associations that link an odor with a taste's quality and hedonic value (pleasantness/unpleasantness) and creates the perception of a congruent odor-taste combination. Previous human psychophysical experiments demonstrate that experience with odor-taste mixtures shapes perceptual judgments related to the intensity, familiarity, and pleasantness of chemosensory stimuli. However, how these perceptual judgments inform consummatory choice is less clear. Using rats as a model system and a 2-bottle brief-access task, we investigated how experience with palatable and unpalatable odor-taste mixtures influences consummatory choice related to odor-taste congruence and stimulus familiarity. We found that the association between an odor and a taste, not the odor's identity or its congruence with a taste, informs consummatory choice for odor-taste mixtures. Furthermore, we showed that the association between an odor and a taste, not odor neophobia, informs consummatory choice for odors dissolved in water. Our results provide further evidence that the association between an odor and a taste, after odor-taste mixture experience, is a fundamental feature guiding consummatory choice.

Sweetness Enhancement by Aromas: Measured by Descriptive Sensory Analysis and Relative to Reference Scaling

Sweetness enhancement by aromas has been suggested as a strategy to mitigate sugar reduction in food products, but enhancement is dependent on type of aroma and sugar level. A careful screening of aromas across sugar levels is thus required. Screening results might, however, depend on the method employed. Both descriptive sensory analysis and relative to reference scaling were therefore used to screen 5 aromas across 3 sucrose concentrations for their sweetness-enhancing effects in aqueous solutions. In the descriptive analysis, samples with added vanilla, honey, and banana aroma were rated as significantly sweeter than samples with added elderflower or raspberry aroma at all sucrose concentrations. In relative to reference scaling, honey aroma significantly increased the sweet taste compared with samples with added elderflower or no aroma at low and medium sucrose concentrations. Banana and raspberry aromas also increased the sweet taste significantly compared with the sample with added elderflower aroma at medium sucrose concentration in the relative to reference scaling. This demonstrates that the cross-modal effects observed by the 2 methods were different. In terms of the methods applied, relative to reference scaling was generally found to result in a decrease in the measured sweetness enhancement by aromas. In the descriptive analysis, the cross-modal effect of aromas on sweet taste perception was found to be significantly higher at 2.5% and 5.0% w/w sucrose compared with 7.5% w/w sucrose. These results highlight the importance of considering how references are employed in sensory analysis and how they affect cross-modal interactions.

Identification of an Amygdala-Thalamic Circuit That Acts as a Central Gain Mechanism in Taste Perceptions

Peripheral sources of individual variation in taste intensity perception have been well described. The existence of a central source has been proposed but remains unexplored. Here we used functional magnetic resonance imaging in healthy human participants (20 women, 8 men) to evaluate the hypothesis that the amygdala exerts an inhibitory influence that affects the "gain" of the gustatory system during tasting. Consistent with the existence of a central gain mechanism (CGM), we found that central amygdala response was correlated with mean intensity ratings across multiple tastants. In addition, psychophysiological and dynamic causal modeling analyses revealed that the connection strength between inhibitory outputs from amygdala to medial dorsal and ventral posterior medial thalamus predicted individual differences in responsiveness to taste stimulation. These results imply that inhibitory inputs from the amygdala to the thalamus act as a CGM that influences taste intensity perception.SIGNIFICANCE STATEMENT Whether central circuits contribute to individual variation in taste intensity perception is unknown. Here we used functional magnetic resonance imaging in healthy human participants to identify an amygdala-thalamic circuit where network dynamics and connectivity strengths during tasting predict individual variation in taste intensity ratings. This finding implies that individual differences in taste intensity perception do not arise solely from variation in peripheral gustatory factors.

Neural Isolation of the Olfactory Bulbs Severely Impairs Taste-Guided Behavior to Normally Preferred, But Not Avoided, Stimuli

Here we systematically tested the hypothesis that motivated behavioral responsiveness to preferred and avoided taste compounds is relatively independent of the olfactory system in mice whose olfactory bulbs (main and accessory) were surgically disconnected from the rest of the brain [bulbotomy (BULBx)]. BULBx was confirmed histologically as well as functionally with the buried food test. In brief access taste tests, animals received 10-s trials of various concentrations of a taste compound delivered quasirandomly. BULBx C57BL/6 (B6) mice displayed severely blunted concentration-dependent licking for the disaccharide sucrose, the maltodextrin Maltrin, and the fat emulsion Intralipid relative to their sham-operated controls (SHAM B6). Licking for the noncaloric sweetener saccharin was also blunted by bulbotomy, but less so. As expected, mice lacking a functional “sweet” receptor [T1R2+T1R3 knockout (KO)] displayed concentration-dependent responsiveness to Maltrin and severely attenuated licking to sucrose. Like in B6 mice, responsiveness to both stimuli was exceptionally curtailed by bulbotomy. In contrast to these deficits in taste-guided behavior for unconditionally preferred stimuli, BULBx in B6 and KO mice did not alter concentration-dependent decreases for the representative avoided stimuli quinine and citric acid. Nor did it temper the intake of and preference for high concentrations of affectively positive stimuli when presented in long-term (23-h) two-bottle tests, demonstrating that the surgery does not lead to a generalized motivational deficit. Collectively, these behavioral results demonstrate that specific aspects of taste-guided ingestive motivation are profoundly disturbed by eliminating the anatomic connections between the main/accessory olfactory bulbs and the rest of the brain.

Influences of Age, Sex and Smoking Habit on Flavor Recognition in Healthy Population

(1) Background: Flavor is one of the main factors influencing food preferences and dietary choices, and a reduction in flavor recognition has been associated with several diseases. A novel quantitative test to assess flavor has been recently developed and validated. The aim of the present work was to define the standard of flavor recognition in the general healthy population. (2) Methods: Three hundred and forty-eight healthy volunteers (18–80 years) performed the flavor test (FT). The test consisted of the oral administration of aqueous aromatic solutions, identifying 21 different compounds. Flavor score (FS) was calculated as the sum of the properly recognized flavors (range 0–21). (3) Results: Normal ranges for FT were produced. Flavor recognition was found to decrease with age. Females obtained slightly higher scores than males, mostly at older ages. Cigarette smoking seemed not to influence flavor recognition. (4) Conclusion: The normal values found for the flavor test in the healthy population will allow its usage as a diagnostic tool in several diseases.

Memory and preparedness in evaluative conditioning in a smell-taste paradigm. A registered report

We investigate two questions, (1) the relevance of memory for evaluative conditioning (EC) effects based on smell-taste pairings, and (2) the potential preparedness of smell-taste combinations for yielding EC effects. The relevance of memory for EC effects is a subject of intense research. The majority of studies that investigate the memory-EC relation use visual stimuli and typically show no or relatively small EC effects without memory. For smell-taste combinations, only a few studies exist, with mixed results regarding the role of memory in EC. The idea that there might be a preparedness of smell and taste pairings comes from classical conditioning studies showing preparedness in food aversion and from research on joint processing of smells and tastes. In Experiment 1, we report a conceptual replication of previous studies with smell-taste and picture-taste pairings. In this experiment, we found no evidence for memory-independent EC overall. In a pre-registered Experiment 2, we used a design with smells, pictures, tastes, and sounds to test the role of memory more conclusively and test the preparedness hypothesis for smell-taste pairings. The results support the preparedness hypothesis for smell-taste pairings in EC. Furthermore, as in Experiment 1, we did not find evidence for memory-independent EC.

The Influence of Teacup Shape on the Cognitive Perception of Tea, and the Sustainability Value of the Aesthetic and Practical Design of a Teacup

The ceramic industry is among the most profitable industries in the world, but, because of the use of nonrenewable materials and high fuel consumption, it also has a carbon footprint. Ceramic materials account for the majority of drinking vessels. Several scholars found that consumers’ awareness of drinks and purchasing desires are highly correlated with a vessel’s shape and color—in other words, the visual stimulation. However, since prior studies have focused on alcohol, bubble drinks, juice, coffee, cocoa, etc., there has rarely been any research on the appropriate drinking vessels for Chinese tea. This study intends to investigate the visual design of vessels for Chinese tea, in terms of its impact on the taste of the drink, by integrating the thinking and methods of expert users and designers for the sustainability of design and industry. In this study, tea experts and designers were asked for their opinions as a means of data collection. Fuzzy set qualitative comparative analysis (Fs/QCA) was used for data analysis. This study proved that the design of a tea-drinking vessel could have an influence on the perception of the taste and scent of the tea. This research not only brings new meaning to the traditional concept of teacup design, but also reflects famous Japanese craftsman Liu Zongyue’s idea of practical beauty, which is beneficial to promoting Chinese tea culture, and contributes to sustainable design and sustainable behavior.

The texture and taste of food in the brain

Oral texture is represented in the brain areas that represent taste, including the primary taste cortex, the orbitofrontal cortex, and the amygdala. Some neurons represent viscosity, and their responses correlate with the subjective thickness of a food. Other neurons represent fat in the mouth, and represent it by its texture not by its chemical composition, in that they also respond to paraffin oil and silicone in the mouth. The discovery has been made that these fat-responsive neurons encode the coefficient of sliding friction and not viscosity, and this opens the way for the development of new foods with the pleasant mouth feel of fat and with health-promoting designed nutritional properties. A few other neurons respond to free fatty acids (such as linoleic acid), do not respond to fat in the mouth, and may contribute to some "off" tastes in the mouth. Some other neurons code for astringency. Others neurons respond to other aspects of texture such as the crisp fresh texture of a slice of apple versus the same apple after blending. Different neurons respond to different combinations of these texture properties, oral temperature, taste, and in the orbitofrontal cortex to olfactory and visual properties of food. In the orbitofrontal cortex, the pleasantness and reward value of the food is represented, but the primary taste cortex represents taste and texture independently of value. These discoveries were made in macaques that have similar cortical brain areas for taste and texture processing as humans, and complementary human functional neuroimaging studies are described.

Enhancement of electroencephalogram activity in the theta-band range during unmatched olfactory-taste stimulation

The aim of this study was to investigate how odor stimulation affects taste perception. Electroencephalogram (EEG) signals were measured from the frontal region of the head in normal, healthy subjects, and frequency analyses were performed. Each odor stimulation was delivered while the subject was tasting chocolate, using chocolate paste as the odorant for 'matched odor stimulation,' and garlic paste for 'unmatched odor stimulation.' Differences in EEG signals appeared between the matched and unmatched arms of the study. Comparison of the frequencies of EEGs captured under the condition of unmatched odor stimulation with those captured under the condition of matched odor stimulation showed that the occupancy rate of the theta-frequency band under the condition of unmatched odor stimulation was higher than that under the condition of matched odor stimulation. Interestingly, a negative correlation existed between the occupancy rate of the theta-frequency band and the subjective feeling of chocolate sweetness. The present findings suggest that when humans receive odors that do not match with the foods being consumed, subjective feelings are disturbed and theta-band brain activity is increased while the unmatched information is cross-checked.

Neural Mechanisms for Accepting and Rejecting Artificial Social Partners in the Uncanny Valley

Artificial agents are becoming prevalent across human life domains. However, the neural mechanisms underlying human responses to these new, artificial social partners remain unclear. The uncanny valley (UV) hypothesis predicts that humans prefer anthropomorphic agents but reject them if they become too humanlike—the so-called UV reaction. Using fMRI, we investigated neural activity when subjects evaluated artificial agents and made decisions about them. Across two experimental tasks, the ventromedial prefrontal cortex (VMPFC) encoded an explicit representation of subjects' UV reactions. Specifically, VMPFC signaled the subjective likability of artificial agents as a nonlinear function of humanlikeness, with selective low likability for highly humanlike agents. In exploratory across-subject analyses, these effects explained individual differences in psychophysical evaluations and preference choices. Functionally connected areas encoded critical inputs for these signals: the temporoparietal junction encoded a linear humanlikeness continuum, whereas nonlinear representations of humanlikeness in dorsomedial prefrontal cortex (DMPFC) and fusiform gyrus emphasized a human–nonhuman distinction. Following principles of multisensory integration, multiplicative combination of these signals reconstructed VMPFC's valuation function. During decision making, separate signals in VMPFC and DMPFC encoded subjects' decision variable for choices involving humans or artificial agents, respectively. A distinct amygdala signal predicted rejection of artificial agents. Our data suggest that human reactions toward artificial agents are governed by a neural mechanism that generates a selective, nonlinear valuation in response to a specific feature combination (humanlikeness in nonhuman agents). Thus, a basic principle known from sensory coding—neural feature selectivity from linear–nonlinear transformation—may also underlie human responses to artificial social partners.

SIGNIFICANCE STATEMENT Would you trust a robot to make decisions for you? Autonomous artificial agents are increasingly entering our lives, but how the human brain responds to these new artificial social partners remains unclear. The uncanny valley (UV) hypothesis—an influential psychological framework—captures the observation that human responses to artificial agents are nonlinear: we like increasingly anthropomorphic artificial agents, but feel uncomfortable if they become too humanlike. Here we investigated neural activity when humans evaluated artificial agents and made personal decisions about them. Our findings suggest a novel neurobiological conceptualization of human responses toward artificial agents: the UV reaction—a selective dislike of highly humanlike agents—is based on nonlinear value-coding in ventromedial prefrontal cortex, a key component of the brain's reward system.

The Role of Intrinsic and Extrinsic Sensory Factors in Sweetness Perception of Food and Beverages: A Review

When it comes to eating and drinking, multiple factors from diverse sensory modalities have been shown to influence multisensory flavour perception and liking. These factors have heretofore been strictly divided into either those that are intrinsic to the food itself (e.g., food colour, aroma, texture), or those that are extrinsic to it (e.g., related to the packaging, receptacle or external environment). Given the obvious public health need for sugar reduction, the present review aims to compare the relative influences of product-intrinsic and product-extrinsic factors on the perception of sweetness. Evidence of intrinsic and extrinsic sensory influences on sweetness are reviewed. Thereafter, we take a cognitive neuroscience perspective and evaluate how differences may occur in the way that food-intrinsic and extrinsic information become integrated with sweetness perception. Based on recent neuroscientific evidence, we propose a new framework of multisensory flavour integration focusing not on the food-intrinsic/extrinsic divide, but rather on whether the sensory information is perceived to originate from within or outside the body. This framework leads to a discussion on the combinability of intrinsic and extrinsic influences, where we refer to some existing examples and address potential theoretical limitations. To conclude, we provide recommendations to those in the food industry and propose directions for future research relating to the need for long-term studies and understanding of individual differences.